Individual
DR. SUSAN ELIZABETH SHAMBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18371
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08109560
—
MS
01
—
P01728790
RR MEDICARE
MS
Enumeration date
12/01/2006
Last updated
11/28/2016
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